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Choline Is Crucial for Liver Health

Choline, found in ample amounts in egg yolks, was first discovered in 1862.1 Since then, we've learned that this is a truly essential nutrient for a healthy brain, nervous system and cardiovascular function. It's particularly crucial during fetal development,2 so choline requirements rise exponentially in pregnant women.3

Importantly, choline is used in the synthesis of phospholipids in your body, the most common of which is phosphatidylcholine, better known as lecithin, which is required for the composition of your cell membranes.4 As noted in a 2013 paper:5

"Humans must eat diets containing choline because its metabolite phosphatidylcholine constitutes 40 to 50 percent of cellular membranes and 70 to 95 percent of phospholipids in lipoproteins, bile and surfactants …

[It] is needed to form acetylcholine, an important neurotransmitter; its metabolite betaine is needed for normal kidney glomerular function, and perhaps for mitochondrial function; and it provides one-carbon units, via oxidation to betaine, to the methionine cycle for methylation reactions.

There is a recommended adequate intake for choline (about 550 mg/day), but choline intake in the diet has been estimated to vary by as much as threefold — the lowest quartile and the highest quartile of intake were approximately 150 mg and 500 mg/day choline equivalents, respectively…"

Studies also stress its importance for liver health, and it may actually be a crucial key for the prevention of fatty liver disease — including nonalcoholic fatty liver disease (NAFLD), which is largely driven by high-sugar diets as opposed to excess alcohol consumption.

Nine in 10 Americans Are Deficient in Choline

Although a small amount of choline is produced by your liver,6 the rest must be supplied through your diet. Unfortunately, an estimated 90 percent of the U.S. population are deficient in choline.7 People who are at particularly high risk for deficiency include:

  • Pregnant mothers — Choline is required for proper neural tube closure,8 brain development and healthy vision.9 Research shows mothers who get sufficient choline impart lifelong memory enhancement to their child due to changes in the development of the hippocampus (memory center) of the child's brain.10 Choline deficiency also raises your risk of premature birth, low birth weight and preeclampsia.
  • Athletes — During endurance exercise, such as a marathon, choline levels deplete. Choline supplementation before severe physical stress has demonstrated a number of advantageous effects in studies.11,12 Choline supplementation may also reduce body mass without side effects.13
  • High alcohol consumers — Excess alcohol consumption can increase your need for choline and raise your risk of deficiency.14
  • Postmenopausal women — Lower estrogen concentrations in postmenopausal women increases their risk of organ dysfunction in response to a low-choline diet, so their requirements are higher than those of premenopausal women.15
  • Vegans — Choline supplementation may also be important for this demographic, as they have an elevated risk for deficiency if they avoid choline-rich foods such as eggs and meats.16


Choline Is Required for Optimal Health

Choline was officially recognized as an essential nutrient for human health by the Institute of Medicine in 1998.17 It's required for:

  • Cell messaging, by producing cell-messaging compounds18
  • Cell structure; making fats to support the composition of your cell membranes
  • Fat transport and metabolism, as choline is needed to carry cholesterol from your liver, and a choline deficiency could result in excess fat and cholesterol buildup19
  • DNA synthesis
  • Nervous system health (choline is necessary for making acetylcholine, a neurotransmitter involved in healthy muscle, heart and memory performance)


Studies have linked higher choline intake to a range of benefits, including a decreased risk for heart disease,20 a 24 percent decreased risk for breast cancer,21 and the prevention of NAFLD. In fact, choline appears to be a key controlling factor in the development of fatty liver, likely by enhancing secretion of very low density lipoprotein (VLDL) particles in your liver.22

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